胰十二指肠切除术中胰管空肠黏膜接触式吻合的应用研究  

Clinical application of the pancreatic duct and jejunum mucosa contacting anastomosis in pancreaticoduodenectomy

作　　者：马吉安[1] 张贵清[1] 谭孝华[1] 刘维政[1] 邹华[1] 贾学峰[1] 潘毅[1] 李文碧[1] 

机构地区：[1]达州市中西医结合医院肝胆外科,四川省635000

出　　处：《中华普外科手术学杂志（电子版）》2016年第5期410-413,共4页Chinese Journal of Operative Procedures of General Surgery(Electronic Edition)

基　　金：达州市科技局科研课题(2060402)~~

摘　　要：目的比较两种胰肠吻合方式对胰十二指肠切除(PD)术后并发症的影响,探讨胰管空肠黏膜接触式吻合在胰十二指肠切除术中的应用价值。方法回顾性分析2014年4月至2016年6月56例接受胰十二指肠切除术的患者资料。根据胰肠吻合方式分为胰管空肠黏膜接触式吻合组和胰管空肠黏膜对黏膜吻合组,每组28例。采用SPSS13.0统计学软件进行数据处理,术中、术后计量资料的描述用x珋±s表示,采用t检验;两组术后并发症分析采用χ2检验;P<0.05有统计学差异。结果胰管空肠黏膜接触式吻合组胰瘘发生1例(3.57%)明显低于胰管空肠黏膜对黏膜吻合组4例(14.28%);两组术后肠功能恢复平均时间分别为(5.3±2.2)d及(7.5±1.8)d,术后平均住院时间分别(17.35±1.52)d及(24.64±1.34)d,差异均有统计学意义(F=2.89及8.92,P均<0.05)。结论胰管空肠黏膜接触式吻合加胰肠端侧吻合在胰十二指肠切除术中可以降低胰瘘的发生,缩短平均住院时间,可以作为胰十二指肠切除术中胰肠吻合的一种选择方法。Objective To Compare postoperative complications by different pancreaticojejunostomy in pancreaticoduodenectomy（ PD） and to evaluate the application value of the pancreatic duct and jejunum mucosa contacting anastomosis. Methods From April 2014 to June 2016,clinical data of 56 patients underwent pancreaticoduodenectomy were analyzed retrospectively. All of 56 patients were divided into observation group（ n = 28） and control group（ n = 28）. patients in observation group received the pancreatic duct and jejunum mucosa contacting anastomosis,while patients in control group received the pancreatic duct jejunum mucosa to mucosa anastomosis. Statistical analysis were performed by using SPSS13. 0 software. Postoperative complications rate were analyzed by χ^2test. Measurement data were presented as x^-± s and examined by using t test. A P valure of〈 0. 05 was considered as significant difference. Results 1 case（ 3. 57%） of pancreatic fistula occurred in observation group,which was significantly lower than 4 cases（ 14. 28%） in control group. Time of recovery of intestinal function in observation group and control group was（ 5. 3 ± 2. 2） d and（ 7. 5 ± 1. 8） d respectively,while hospital stay after operation of（ 17. 35 ± 1. 52） d and（ 24. 64 ± 1. 34） d,with significant differences（ F = 2. 89 and8. 92,P〈0. 05）. Conclusions The pancreatic duct and jejunum mucosa contacting anastomosis could reduce the occurrence of pancreatic fistula in pancreaticoduodenectomy and could shorten hospital stay,which is worth of a optional pancreatic anastomosis method in pancreaticoduodenectomy.

关 键 词：胰腺疾病 胰十二指肠切除术 胰管空肠吻合术 胰腺瘘 

分 类 号：R656[医药卫生—外科学]